chemo vs cancer, science vs disease

In another few weeks it’ll be 27 years since my mother died of metastatic breast cancer. Not a nice way to go – but eased by a very caring family GP and the wonderful people at the local hospice, who helped her die with dignity at home.

I was reminded of this by reading David Gorski’s recent post on Science-Based Medicine: chemotherapy vs death from cancer. In the US at least (although I suspect here as well), ‘alternative practitioners’ offer a wide range of ‘therapies’ for people with cancer, claiming ‘natural cures’ & the option of ‘dying healthy’ if you must die at all. Unfortunately for those choosing this option, modern chemotherapy really is the best treatment option for many cancers (alongside radiotherapy & surgery, depending on how the disease manifests itself). If those alternative therapies worked they’d have become part of the mainstream pharmacopaeia by now. Dr Gorski agrees that yes, chemo can be quite brutal in its effects – but the cancers it is aimed at are at least as bad. (The reason chemo can have serious side effects is that it’s a fine line between killing the cancerous cells & killing normal tissues.)

Anyway, Dr Gorski’s article led me to think about the way that other proponents of ‘alternative therapies’ make special claims for their own products, and level all sorts of accusations against mainstream medicine. Over on SciBlogs, for example, a local anti-vaccination advocate was quoted in the comments thread for an article on vaccination that the sooner New Zealand drops all vaccinations, the better. In support of their views that vaccinations are Bad, Bad, Bad, the commenters on that thread trotted out all the usual claims: that vaccines cause autism (false – there are no data to support this claim); that vaccines contain ‘neurotoxic’ materials including formaldehyde (true, but our bodies make far more of this, during normal metabolic processes, than is contained in any dose of a vaccine); that vaccines contain ‘aborted foetal tissues’ & ‘monkey kidneys’ (serious scare tactics, these, & also false). These claims have been ably addressed elsewhere, both on SciBlogs & on overseas sites such as Science-Based Medicine & Orac’s Respectful Insolence.

But I wonder – do the people advocating a complete cessation of vaccination really seriously think about the consequences of this? My mother contracted polio as a teenager in the 1930s. She was lucky – the virus ‘only’ paralysed nerves in her hand and leg. She recovered, but for the rest of her life the muscles in those areas were smaller & weaker than on the unaffected side. She never had to spend time in an iron lung – and at the height of polio epidemics, some overseas hospitals had entire wards devoted to patients in these machines, which ‘breathed’ for people who could no longer breathe for themselves because the necessary muscles were paralysed. Mortality rates from polio – before the widespread availability of a reliable vaccine – were around 5%, with a further 35% of those infected suffering some level of paralysis.

Or what about diphtheria? The mortality rate for this bacterial disease is between 5 & 10%, & outbreaks still occur, even in industrialised nations. Diphtheria often has respiratory symptoms, due in part to severely swollen lymph nodes in the neck. But the bacterium (Clostridium diphtheriae) also produces metabolic by-products that can lead to damage to the heart & nerves, & it can sometimes cause serious secondary infections in the skin.

And there’s measles, whooping cough, rubella – while in the industrialised world, with its generally good provision of health care, most of those who contract these infections go on to recover, they are not trivial diseases. (I couldn’t believe one comment I read a few months ago, where the writer commented that whooping cough was a trivial illness; her child had ‘only’ had a serious cough for a week… & was unwell for several more.) All have a rate of serious complications, including death, that is several orders of magnitude higher than the unquestioned rate of complications due to vaccination.

And I wonder – are people so ready to advocate a return to a world where these diseases are common because they’ve never had first-hand experience of the effects? After all, the highest rates of illness occur in the ‘third world’, which is a long way from the experiences of most people in comfortably first-world New Zealand. And is part of it due to a failure on the part of scientists, doctors, the education system at large to help people understand things like relative risk, and how science-based medicine operates? And – a key part of this – how well do we communicate the idea that correlation does not equal causation: that because B happens soon after A, for example, this is not proof that A caused B?

PS And those with a genuine interest on what <i>is</i> in vaccines (as opposed to the wilder claims being made over at Sciblogs) might like to read this post from ERV: – basically a group of researchers did DNA analysis on most of the main vaccines, looking for evidence of contamination from other sources (monkey tissue, foetal tissue, etc etc). The result: modern vaccines are clean.

0 Responses to “chemo vs cancer, science vs disease”

Alison, what a great post. I think one of the things proponents of alt therapies and anti-vaxxers forget is that scientists and doctors also lose family and friends to diseases and that is one of the reasons we support science and medicine. The image of the cold and detached researcher is hopefully changing thanks to fora like sciblogs and it great when those like yourself share such stories. This year I lost one of my aunts to ovarian cancer. Ovarian cancer has a poor prognosis and she underwent the maximum number of rounds of chemo and radiotherapy (7 I think) which was quite brutal but gave her more time with my cousins and their kids.
I think fora such as sciblogs are overcoming one of the reasons that alt med and antivaxxers have succeeded more than they should have. Many scientists become so wrapped up in their work, publish or perish and finding funding that we forget that we have an important role in communicating science to the public. I remember being so focused on my lab work early on in my career that i didn’t even bother explaining what I was doing to my partner as it “was too complicated, and would take too long to explain”
Alt med and anti vaxxers also assume that we don’t understand their point of view, however I have looked at many of their “therapies” and found them wanting both in making sense scientifically and in being able to demonstrate results.
I think one of the appeals of alt med is that it offers the perception of control over one’s disease, particularly when conventional treatment offer limited documented hope.
I think the biggest thing scientists can offer society is information. If we can keep communicating the science clearly we will make headway.

I wonder if some parents acceptance of antivaxxers arguments is perhaps an opportunity to apportion blame for the unprepared circumstance of having an autistic child. Many parents often blame themselves for things that happen to their children (everything from injuries to a child’s sexuality) so when a child has autism perhaps the opportunity to identify a external “cause” makes them feel better?
I think the internet also plays a role, in that erroneous information can be circulated faster and to a wider population and repeated over and over – I think it has been well established that if you repeat a lie over and over again people start to believe it. Perhaps when science fact is repeated over and over again on place such as sciblogs we will start to counter the false information.

I agree; I think that there’s quite a strong tendency for people to want to apportion ‘blame’ for things like this. Most parents want to do the best for their children & it can be hard to accept that in some circumstances nothing you could have done would change an outcome for that child.

Well better to saw prevention is better than sure for cancer rather than investigating which treatment will ensure “heathly death”.

Well as far as breast cancer is concerned a recent study found out that drink water from cans that kept long time near car engine heat will cause cancer. Because the heat make the plastic to melt and dissolve in water and you drink that contaminated water even though it cool clean to ur naked eyes.

For many more knowledge about cancer will prevent them from the cancer exposure. Cancer occurs when you have ur body to contaminated or unusually environment like high heat,polluted air like construction particles in air and in taking contaminated foods like the can water i mentioned

Yes we can aim for prevention, but realistically it’s not always possible. Thus there will always be a need for science-based treatments that may offer a cure or, if not, the possibility of living a bit longer as comfortably as possible.
I’d be interested in reading more about your breast cancer example – can you provide a reference for this? (Note that there’s no obvious link between breast cancer per se & the possibility of taking in carcinogens that have leached from plastic (you mention cans?) into drinking water.

BioBlog is the home of Dr Alison Campbell, a science communicator and senior lecturer in biological sciences at the
University of Waikato. You'll find a fair bit of biology here and ruminations on science in general.

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